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A Nominal Agenda to Reduce Work Stress

An unstructured approach to problem solving may not ensure that all voices are heard–that's when the nominal group technique is effective.

by Scott Warner
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Work stress has become a dominant factor in our workplace and it affects all of us. As a manager, you may be coping with a chronic staffing shortage, recent layoffs, a rash of errors that has eroded confidence, or a turnover in senior administration. If you’re new to the job, you may not understand the problem. Your secret weapon to create a work agenda that combats stress just might be the nominal group technique.

Work has always been stressful, you say. And you’re right. After all, if it were fun, it wouldn’t be called work. It’s tempting to view stress as an individual’s problem. But the latest trends suggest that our society is changing in ways that create even more stress, making it difficult to shrug off.

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Information technology and a global economy contribute to an out-of-control work environment. As customer demands increase, we depend more on technology to deliver. This “informatization” of our workplace is double-edged; we not only use but need to produce information in ever-increasing amounts. Productivity may be higher, but more skill is needed.

The price of stress

One study cites a third of U.S. workers as overwhelmed and seven out of ten want a different job. One reason is technology. Cell phones, pagers, computers, and other devices that didn’t exist a few decades ago create a constant need to be accessible and add stress.1

There are disturbing signs that the trends are real. Similar to the phenomenon of “road rage” on overcrowded highways, work stress is causing “desk rage” on the job. One study reports that 42 percent of Americans say that yelling or verbal abuse takes place at their job, and nearly a third of those have themselves yelled at co-workers. One in seven report ragedriven destruction of property. The end costs are employee tardiness, absenteeism, and turnover.2

Most alarmingly, work stress is linked to heart disease in a 14-year study published recently by the British Medical Journal.3 Civil servants exposed to chronic stressors are nearly twice as likely to develop metabolic syndrome that increases the risk of heart disease and type-2 diabetes. Physiological disorders as well as lifestyle changes may be the cause. The study shows a “dose-response relationship” in which workers’ health-damaging behaviors are in proportion to the amount of stress.

As a manager, you may think that stress is unavoidable for some people, a feeling buoyed by research that focuses on how it affects individuals. But we also know that workers need freedom in how to respond to job demands in order to reduce stress. Those in high-strain, lowcontrol jobs are three times more likely to have a heart attack as those in executive positions.4

The little research done on group stress shows that overall performance suffers. One study comparing groups of Navy technical school personnel suggests that a higher level of stress narrows the focus of the group from team to individual goals.5

A new manager can be blind-sided by a group culture that may have developed without the awareness of upper management. Long-term effects of an “each man for himself” mentality may foment hostility, dissolve a team, or empower a “shadow organization” negative culture as the group loses perspective. In the long term, work stress can make your job all the more difficult.

It’s also tempting to accept this stress as part of our world, perhaps as a price for new technology. To some degree, a work culture that views stress as not only inevitable but necessary in order to compete and generate profit pays an ultimate human cost.

The nominal group technique

As the National Institute for Occupational Safety and Health points out, there is a difference between harmful stress and a work challenge or so-called “good stress.” Work that is challenging is energizing and motivating. Work stress occurs when expectations are too high, which, in the long run, makes a job unsafe and unhealthy. The good news is that some of the working conditions that can create stress listed in Table 1 are probably under your control.6 You may be able to turn bad stress into good.

Lack of individual control in how to respond appears to be at the root of work stress. Other causes are a lack of participation in decision making and uncertainty about expectations. A good first step is to allow the group to identify these subjective perceptions.

Group exercises like brainstorming can help identify stressors and get a group back on track, but individuals who wield power within the group can make this difficult. These individuals may not be immediately apparent. And an unstructured approach to problem solving may not ensure that all voices are heard. These conditions may occur when negative “groupthink” takes over after prolonged periods of stress. That’s when the nominal group technique (NGT) is effective.

A nominal group is brought together solely to generate ideas. While brainstorming uses a freewheeling, spontaneous approach, NGT is more structured. Both are suited to dealing with poorly understood or complex problems, but NGT keeps individuals from dominating meetings, insulating the process from politics. This helps a group work together quickly to help find solutions.

Here are the steps:
  1. Begin with a group of five but no more than ten participants, with you acting as a facilitator. You’ll need a board or flipchart to write on and a clock.
  2. Choose a meeting space large enough to accommodate members in a U-shape or around a table, and block out a length of time during which you’ll be uninterrupted.
  3. State the problem clearly as an open-ended question. Be sure that the issue framed by the question is understood by all participants. Your terms should be unambiguous. The issue itself is open-ended and may range from an overall agenda (What are the major sources of stress in this laboratory?) to a specific problem (How can we reduce cost?).
  4. Ask the group members to silently jot down their ideas and responses in a set period of time (5–10 minutes).
  5. Collect the ideas in a round-robin fashion, asking each group member in turn to state an idea aloud. You as the facilitator write down the ideas, asking for clarification from the respondent. No criticism or discussion is allowed. A member may also “pass,” in which case no idea is recorded and the next person states an idea. This continues for a set period of time or until all ideas are recorded.
  6. Briefly discuss each idea. This is the time to eliminate duplicates or combine similar ideas, change wording, or delete items by group consensus. Rather than judge the ideas, this step clarifies them without argument.
  7. Number the items and ask members to silently rank order the top 5–10, depending on the length of the list, by writing them down on a piece of paper in a set period of time (5–10 minutes). If each member has five votes, for instance, the most important item is worth five, the next worth four, and so on. The criteria for voting can be open-ended (individual preference) or specific (cost) but should be made clear by you in advance of voting.
  8. Tally the scores either by the members reading their choices aloud in descending order (not anonymous) or by a scribe reading from their score sheets (anonymous), then write the scores beside the individual items.

What this gives you is a prioritized list of items that answer the question posed to the group in a short period of time, maybe as little as 45 minutes. It’s up to you to develop action plans, perhaps with their help. And if you’re a new manager, this technique can give you an agenda that can be a roadmap for success, helping you gain early credibility.

If NGT seems like a complicated way to solve problems, consider that a group is generally better than an individual at solving an unstructured problem.7 You wouldn’t use NGT to add a column of numbers, because addition is clearly understood. It follows that a poorly understood problem (How do we reduce work stress?) needs definition and clarification before taking action, the more creative the better.

The NGT, outlined above with a multi-voting, prioritization method, isn’t perfect as briefly summarized in Table 2. But it has advantages over other techniques, particularly if the group’s dynamics are unknown or the group has been under stress for an extended period of time. If all members in a group (or a series of groups, depending on the size of your staff) are given a voice, NGT can be a powerful, team-building exercise.

Roadblocks can occur. Group members may be familiar with NGT to the point of manipulation; individuals can obstruct the process. You as a facilitator must firmly keep the group focused. A phenomenon of “groupthink” may exist, in which some or all members agree collectively on an irrational course of action. NGT may not only expose this but serve to keep the group grounded in its approach to the problem.

Strict adherence to the technique may produce uncomfortable results. It’s possible, for instance, that you or other members of a work team are causing stress. As noted in Table 1, there can be specific reasons for employees’ dissatisfaction with management. It’s important that you separate the person from the process.

A structured, rational approach to consensus building like NGT helps counter the destructive, chaotic effects of work stress. You may even solve problems, which is a good thing. Managers are stressed, too.

  1. Yearwood, C. The overworked workplace. CNet page. 8/10/01. Available at: Accessed 8/15/6.
  2. Overworked, overwrought: desk rage at work. page. 11/15/00. Available at: Accessed 8/15/6.
  3. Work stress leads to heart disease and diabetes. Science Daily page. 1/24/06. Available at: Accessed 8/15/6.
  4. Adler, V. Little control=lots of job stress in low-echelon jobs. Psychology Today. Apr 1989. Available at: _n4_v23/ai_7502237. Accessed 8/15/6.
  5. Driscoll J, Salas E, Johnston J. “Does stress lead to a loss of team perspective?” Group Dynamics: Theory Research and Practice. 1999; 3(4): 291-302.
  6. NIOSH Publication 99-101: Stress at Work. page. Available at: Accessed 9/7/6.
  7. Meredith J, Mantel S. Group creativity. University of Cincinnati Student Wave page. Available at: resources/addtopics/addtopic_s_01e.html Accessed 8/18/6.